Is it safe to switch vaccines for your COVID booster?
DEAR DR. ROACH: I'm 71 and have had both Moderna COVID-19 vaccination shots. When I called my doctor to inquire about a Moderna booster, I was told one was not available now but that I could take the Pfizer booster. Can you confirm this? I'm a little wary of taking another type of booster shot. -- A.M.
ANSWER: The immunity to COVID-19 from the Moderna mRNA vaccines seems to be a bit longer-lasting than that for the Pfizer vaccine, and as of this writing, a third dose of either Moderna or Pfizer vaccine is recommended only for people over 65 or who are otherwise at high risk or with frequent institutional or occupational exposure.
Some research has been done on changing the type of vaccine for an individual, and the results are promising that there might be additional benefit to changing. However, the Food and Drug Administration recently advised that any approved COVID-19 vaccine (Pfizer, Moderna or Janssen) may be used. All three provide high protection with low risk.
I am putting some of the newest recommendations on my Facebook page for those who want more detail, facebook.com/drkeithroach.
DEAR DR. ROACH: I am an 88-year-old man. I drool 24/7. Your recent column did not offer a solution. I heard of a drug called hyoscyamine. It is a travel sickness drug, but also is used for drooling. Any ideas if this is effective for drooling? -- J.N.
ANSWER: Drooling can have many causes, and a careful evaluation of any abnormalities in neurological function, dental problems or sinus and nasal inflammation may lead to a specific treatment. When no specific cause can be identified, medications to reduce saliva production can be tried.
Physicians take advantage of the side effect of dry mouth to reduce drooling. In addition to the hyoscyamine, other medications used include: atropine eyedrops under the tongue; the antidepressant amitriptyline; and glycopyrrolate. All have been used successfully. These medications are not usually completely effective but can often help. Care must be taken not to dry the mouth out too much, as this can accelerate dental disease.
For some people, chewing gum or hard candy can encourage swallowing and help with drooling, especially in social situations. In severe cases, botulinum toxin can be injected into the salivary gland.
DEAR DR. ROACH: My husband and I both take atorvastatin (10 mg for me, 20 mg for him). Should we be taking CoQ10? Your recent column suggested that atorvastatin depletes CoQ10? We are 79 and 81 years of age. -- J.J.
ANSWER: I don't recommend CoQ10 supplementation to people who have no noticeable side effects from their statin drug, of any type or dose. In many people who notice symptoms they attribute to the statin, such as muscle or joint aches, the symptoms are not due to the statin. Studies done on prevention of side effects by CoQ10 have failed to show a benefit. However, if a person does have a muscle symptom that seemed to have started at the same time as the statin, the CoQ10 can resolve the symptom in about a third of people (which is about the same as the benefit in the placebo group). Since CoQ10 is safe and relatively inexpensive, about $10 per month for a well-known brand, it is reasonable to try to see if it helps.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
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